Vice President, Network Development & Contracting

centene; Michigan; Hybrid; USD 180,000 - 343,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work schedules (remote/hybrid

Job summary

Centene is seeking an Executive to direct the provider network and contracting activities in the United States. You will lead all aspects of network strategy, access analysis, and provider relations, guiding decisions on reimbursement and unit cost management.

You will oversee contracting, budgeting, forecasting, and market expansion initiatives, with responsibilities spanning staff leadership, analyses of claim trends, and due diligence support for M&A efforts.

Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration or related field required.
• MBA or MHA degree preferred.
• 10+ years of experience in managed care network development and provider relations/contracting management.

Responsibilities

• Direct the provider network and contracting activities and strategy.
• Oversee contracting department operations, negotiations, and cost management.
• Establish strategic vision, objectives, and procedures for the department.
• Lead network development staff and external consultants across expansion markets.
• Analyze provider network from cost, coverage, and growth perspectives.
• Support market expansion and M&A through due diligence on provider contracts.
• Provide leadership to the health plan CEO/COO on vendor relations and strategy.
• Travel as required.

Skills

Provider network strategy

Contracting management

Budgeting & forecasting

Leadership & staff management

Education

Bachelor's degree in Business Administration or Healthcare Administration

MBA or MHA preferred

Job description

Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.

Position Purpose:

Direct the provider network and contracting activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the contracting department.

• Establish the department’s strategic vision, objectives, and policies and procedures.
• Develop, implement and maintain production and quality standards for the Contracting department.
• Oversee network development staff and external consultants in the development of provider networks across expansion markets.
• Perform periodic analyses of the provider network from a cost, coverage, and growth perspective.
• Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
• Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
• Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
• Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
• Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
• Assist health plan CEO and/or COO vendors in key provider relations and strategy.
• Ability to travel.

Education/Experience:

Bachelor's Degree or equivalent experience in Business Administration, Healthcare Administration or related field required. MBA or MHA degree preferred. 10+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment required. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

Pay Range: $180,400.00 - $343,300.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act